Cerebral Palsy, Equinus Foot Deformity in Children With Cerebral Palsy, Gait Analysis in Neurological Disorders
Conditions
Keywords
cerebral palsy, tendon Achilles, open surgery, z-plasty lengthening, needle lengthening technique
Brief summary
This study aims to compare the outcomes of two surgical techniques for Achilles tendon lengthening in ambulatory children with cerebral palsy (CP): the percutaneous needle technique and the traditional open Z-lengthening technique. The primary objective is to evaluate the effectiveness of these techniques in improving ankle dorsiflexion and gait function one year postoperatively. Secondary objectives include assessing postoperative complications, re-rupture rates, and patient satisfaction. The study is designed as a retrospective, matched-pair cohort study, utilizing data from clinical records, 3D gait analysis (3DGA), and structured telephone interviews.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* Ambulatory children with spastic cerebral palsy (unilateral or bilateral). * Indication for Achilles tendon lengthening confirmed by 3D gait analysis. * Underwent unilateral either percutaneous needle technique or open Z-lengthening between 2015 and 2022. * Availability of preoperative and one-year postoperative 3D gait analysis data. * Informed consent obtained.
Exclusion criteria
* Multilevel surgical interventions. * Previous foot surgeries that alter foot anatomy. * Non-compliance with rehabilitation protocols or orthotic use. * Botulinum toxin-A injections in the triceps surae within six months pre- or post-surgery. * Incomplete or inadequate 3D gait analysis data. * Lack of informed consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Passive Ankle Dorsiflexion (Degrees) | Measured with the knee extended at one year postoperatively. | Passive Ankle Dorsiflexion (Degrees) measured with the knee flexed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Active Ankle Dorsiflexion (Degrees) | Measured with the knee extended at one year postoperatively. | Active Ankle Dorsiflexion (Degrees): Measured with the knee extended and flexed. |
| Maximum Ankle Dorsiflexion in Stance Phase | Measured with the knee extended at one year postoperatively. | Maximum Ankle Dorsiflexion in Stance Phase: Kinematic analysis during 3D gait analysis. |
| Propulsive Power in Terminal Stance | Measured with the knee extended at one year postoperatively. | Propulsive Power in Terminal Stance: Measured in watts per kilogram using kinetic analysis. |
| Postoperative Complications | Measured with the knee extended at one year postoperatively. | Postoperative Complications: Incidence of infections, hematoma, and re-ruptures within the first postoperative year. |
Countries
Norway